跨理论模型在孕妇体重管理行为干预中的应用

发布时间：2018-01-06 14:28

本文关键词：跨理论模型在孕妇体重管理行为干预中的应用　出处：《重庆医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：以跨理论模型(The Transtheoretical Model, TTM)为理论基础，对孕期妇女体重增长的相关行为按其所处的行为阶段，，制定并采取针对性行为干预策略，同时评估干预效果，探讨一种基于TTM的孕期体重管理行为干预方法，提高临床上对孕妇体重管理的质量。方法：门诊收集60例肥胖孕妇，按收集时先后顺序依次编号1～60，单号自动进入干预组，双号自动进入对照组。基线评估后，干预组由门诊助产士采取阶段性行为干预策略对其实施体重管理；对照组仅接受助产士常规健康教育。分别在孕12-14周(T0)、孕18-20周（T1）孕22-24周(T2)与孕26周（T3）对两组孕妇的体重管理行为变化阶段、变化过程进行评估与分析，比较其差异性；同时在孕26周比较两组孕妇孕期与助产士沟通次数的差异性。结果： 1.干预前两组孕妇所处行为阶段分析显示:60例孕妇中,体重管理行为处于前意向或意向或准备阶段的孕妇共56例(93%),处于行动或保持阶段的孕妇所占比例极少。 2.干预后资料分析：对两组孕妇在不同干预时点的体重管理行为变化的指标进行组间比较,结果显示:基线TO时,两组孕妇在行为变化阶段、变化过程方面差异均无统计学意义(P＞0.05)；干预后在孕22-24周(T2)、孕26周（T3）,两组孕妇在变化阶段、变化过程方面差异均具有统计学意义(P0.05)；干预后T1时两组孕妇在变化阶段存在统计学差异(P0.05)，而在变化过程方面不存在统计学差异(P＞0.05)。 3.孕26周时，两组孕妇在与助产士的沟通次数上存在显著统计学差异(P0.01)。结论： 1.基于跨理论模型制定的行为干预策略使孕妇体重管理行为所处变化阶段向前推进；同时促使变化过程向有益于体重控制的方向改善。 2.TTM对孕妇孕期体重指数（BMI）、胎儿出生体重等的干预效果有待进一步研究。 3.基于TTM的阶段性行为干预策略，促进了孕妇孕期与助产士的沟通，进而一定程度上提高了助产士对孕妇孕期照护的连续性。
[Abstract]:Objective: to take the Transtheoretical Model (TTM) as the theoretical basis. The behavior related to weight gain of pregnant women was designed and adopted targeted behavioral intervention strategies according to their behavior stage, and the intervention effect was evaluated at the same time. To explore a method of intervention of pregnant weight management based on TTM to improve the quality of pregnant women's weight management. Methods: 60 obese pregnant women were collected from outpatient clinic, numbered 160 in order of collection, single number automatically entered the intervention group, double number automatically entered the control group, and after baseline evaluation. In the intervention group, the outpatient midwives carried out the weight management by the phased behavioral intervention strategy. The control group only received midwife routine health education in 12-14 weeks of gestation (T0). The changes of body weight management behavior in the two groups were evaluated and analyzed, and the differences were compared between 18 and 20 weeks of gestation (22-24 weeks) and 26 weeks of gestation (P < 0.05). At the same time, the differences of communication times between pregnant women and midwives were compared between the two groups at 26 weeks of gestation. Results: 1. The behavioral stage analysis of the two groups of pregnant women before intervention showed that 56 of 60 pregnant women with weight management behavior were in the former intention or intention or preparation stage. The proportion of pregnant women in the active or maintenance phase is very low. 2. Analysis of post-intervention data: the changes of weight management behavior of pregnant women in two groups were compared at different intervention time points. The results showed that: at baseline to, the two groups of pregnant women were in the stage of behavior change. There was no significant difference in the process of change (P > 0.05). After intervention, there were significant differences between the two groups in the phase of change and the process of change (P 0.05) at 22-24 weeks of gestation and 26 weeks of gestation. There was a statistical difference between the two groups at T1 after intervention in the stage of change, but there was no statistical difference in the process of change (P > 0.05). 3. At the 26th week of gestation, there was a significant difference between the two groups in the frequency of communication with the midwife (P 0.01). Conclusion: 1.Behavioral intervention strategies based on cross-theoretical model can push forward the changing stage of pregnant women's weight management behavior and improve the change process towards the direction beneficial to weight control. 2. The intervention effect of TTM on pregnancy body mass index (BMI) and fetal birth weight (FBW) of pregnant women needs further study. 3. The phased behavioral intervention strategy based on TTM promotes the communication between pregnant women and midwives, and to some extent improves the continuity of midwives' care during pregnancy.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R473.71

【参考文献】